Healthcare Provider Details

I. General information

NPI: 1871900357
Provider Name (Legal Business Name): BRANDY L HUYCK LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S SAGINAW ST STE C
FLINT MI
48503-3705
US

IV. Provider business mailing address

420 W 5TH AVE
FLINT MI
48503-2445
US

V. Phone/Fax

Practice location:
  • Phone: 810-496-5452
  • Fax:
Mailing address:
  • Phone: 810-496-5452
  • Fax: 810-496-5776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801118710
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: